Am I a candidate?!?

[MissKacey 0]

Hi, I'm with Kaiser insurance (and somehow have been since I was born!) and I'm just starting my Lap Band process.

Now, my BMI is 38.0, but because I'm 4'10" this much weight on such a short stature is considered severely obese.

My question is; Will Kaiser automatically deny me because my BMI isn't at 40 or higher, or will they take my short stature and medical problems into account?

Any information and helpful opinions would be greatly appreciated!

[RestlessMonkey 7]

BMI uses height as part of the formula to get your BMI so that won't "matter more". However other than that I don't know what Kaiser's requirements are, but I can tell you that your best bet is to call them and find out what their prerequisites are. Each insurance is different and different employes may modify them (by omitting bariatric surgery, for example) to save costs. So people with Kaiser won't necessarily have the same coverage. Good luck!

[Jodi_620 37]

It depends on your policy and your current health. Kaiser may cover it in some policies and not cover it in others. The general requirements are BMI of 35-40 with weight related health problems or a BMI above 40. Like RestlessMonkey said, the only one that can tell you for sure is your insurance company, give them a call.

[Florida Pete 1]

First thing I would do is find you explanation of benefits booklet. In there specifically look under exclusions to see if WLS is excluded or not. If it is excluded then the plan you have with Kaiser does not pay for it.

Even though many insurance companies will pay for WLS does not mean that you have a plan with them that includes it. For example I am with BCBS of Florida. They do pay for WLS surgery. BMI 35 to 40 with 2 comorbities. But the plan that my work holds with them has WLS excluded. So it is not covered for me.

So good luck with this and I hope the best for you.